Provider Demographics
NPI:1285747964
Name:ABDALI HAJIABADI, ABDOL HAMID (PA)
Entity type:Individual
Prefix:MR
First Name:ABDOL HAMID
Middle Name:
Last Name:ABDALI HAJIABADI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:HAMID
Other - Middle Name:
Other - Last Name:ABDALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1617 E 1ST ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-6385
Mailing Address - Country:US
Mailing Address - Phone:714-246-0000
Mailing Address - Fax:
Practice Address - Street 1:1617 E 1ST ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-6385
Practice Address - Country:US
Practice Address - Phone:714-246-0000
Practice Address - Fax:888-371-8355
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14479363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical